Faculty

Madeline A Naegle

Professor Emerita

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Professional overview

Dr. Naegle is nationally and internationally known for program development, publications and implementation of policy in addiction and psychiatric nursing, with a focus on older adults. Her activities have included efforts on the integration of behavioral health into health professional education and practice. Her leadership in organized nursing includes development of international consultation and education and establishment of the NYU College of Nursing WHO Collaborating Center in Geriatric Nursing Education. She is a Health and Aging Policy Fellow, Class of 2016-17 and serves as Associate Director, RMCON Center for Drug Use and HIV Research.

Continuing Links Between Substance Use and HIV Highlight the Importance of Nursing Roles

Links between HIV and substance use were identified early in the U.S. HIV epidemic. People who use drugs are at risk of HIV infection through shared injection equipment and risky sexual behaviors. In addition, substance use has negative health consequences for people living with HIV. The prescription opioid misuse epidemic, linked to injection drug use, hepatitis C infection, and HIV, poses a new threat to declining HIV rates. We reviewed evidence-based interventions that decrease HIV risk in people who use drugs (needle/syringe programs, medication-assisted treatment, engagement in HIV care, and preexposure prophylaxis/postexposure prophylaxis). The critical roles of nurses in HIV prevention/care for this population are described, including applying the principles of harm reduction, screening for substance use, and undertaking implementation and research efforts. As the nation's largest health care profession, nurses are positioned to contribute to the quality of HIV-related prevention/care for people who use drugs and to lead practice initiatives.

Nursing Education to Reduce Use of Tobacco and Alternative Tobacco Products: Change Is Imperative

BACKGROUND: Tobacco use continues to be the leading cause of preventable death worldwide. OBJECTIVE: To assess perceived tobacco educational preparation of undergraduate and graduate nurses in a large urban university. DESIGN: A cross-sectional web-based survey of all nursing students in an urban college of nursing was conducted to assess perceived tobacco educational content, skills, and self-efficacy for cessation counseling with patients who smoke cigarettes and use alternative tobacco products (e.g., hookah and e-cigarettes). RESULTS: Participants reported the most education about health effects of tobacco use (67%), and less than 6% reported education about alternative tobacco products. While the majority of nurses agreed that advising patients to quit is a priority, less than 40% reported receiving sufficient training in cessation counseling. CONCLUSIONS: There continues to be a compelling need articulated by leaders in tobacco policy and research over the past decade for a more vigorous response by nurses to the tobacco epidemic.

Knowledge, Beliefs, Behaviors, and Social Norms Related to Use of Alternative Tobacco Products Among Undergraduate and Graduate Nursing Students in an Urban U.S. University Setting

Purpose: The purpose of the study was to assess nursing students' knowledge, beliefs, behaviors, and social norms regarding use of alternative tobacco products (ATPs). Design and Methods: This anonymous online survey was conducted with all students enrolled in a college of nursing. The survey utilized measures from several national tobacco studies to assess knowledge and beliefs about ATPs (hookahs, cigars or cigarillos, bidis, kreteks, smokeless tobacco, electronic cigarettes) compared to cigarettes, health effects of ATPs, personal use of ATPs, and social norms. Data were analyzed in SPSS 22.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics and frequencies were performed for basic sociodemographic data. Paired samples t tests were performed to determine differences for scaled measures. Findings: Nursing students demonstrated very low levels of knowledge about ATPs and their health consequences, despite high rates of ATP personal use. About 76% of participants reported use of one or more ATPs once or more in their lifetimes. A greater proportion of students had used hookahs or waterpipes (39.6%) compared to cigarettes (32.7%). Conclusions: Nurses' lack of knowledge about the emerging use and health threats associated with ATPs may undermine their ability to provide appropriate tobacco cessation counseling. Research is needed to identify gaps in nurses' education regarding tobacco cessation counseling and to develop new counseling approaches specific to use of ATPs. Clinical Relevance: Nurses play critical roles in counseling their patients for tobacco cessation. Further research and education about the risks presented by ATPs are critical to reducing excess tobacco-related mortality.

A narrative of the attending nurse model implementation

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Essential psychiatric, mental health and substance use competencies for the registered nurse

The original concept for this document was conceived at the meeting of the Psychiatric Mental Health Expert Panel during the Academy of Nursing 33rd Annual Meeting and Conference, Integrating Physical and Mental Health Care, held in Miami, Florida, November 9-11, 2006. Judith Haber and June Horowitz co-chaired the Expert Panel meeting at the time discussion took place regarding the need for a document centralizing recognized competencies and curricula associated with psychiatric mental health nursing practice. The Expert Panel also recognized the need for a document that identified psychiatric mental health competencies for generalist nursing practice. Catherine Kane and Margaret Brackley agreed to Co-Chair a taskforce to write these competencies. They were joined by Madeline Naegle, Sandra Talley, Marian Newton, Jeanne Clement, Patricia D'Antonio, and Elizabeth Poster. This initial group was charged with using "a model similar to the Hartford Foundation model for building capacity in geriatric nursing to develop PMH/Behavioral Health Competencies for non-PMH RNs and APRNs." Other contributing members of the Taskforce were Edna Hamera, Elizabeth LeCuyer, Mona Shattell, Geri Pearson, Rebecca Harmon and Theodora Sirota. The Taskforce convened by teleconference on April 13, 2007, and met monthly by teleconference through Fall 2008. A full draft of the document was completed and sent for editing to Geraldine Pearson and Beth Vaughn Cole. On March 24, 2009, the Taskforce convened by teleconference and agreed to distribute the draft to the membership of the International Society of Psychiatric Nursing (ISPN), the American Psychiatric Nurses Association (APNA), and the International Nurses Society on Addictions. The draft was displayed on the websites of ISPN and APNA through 2009. Comments, suggestions, edits and revisions were welcomed and the feedback was incorporated into this document. The appendices to this document include materials that informed the content of these Essentials and websites for resources.

The attending nurse: An evolving model for integrating nursing education and practice

The discipline of nursing continues to evolve in keeping with the dramatic expansion of scientific knowledge, technology, and a concomitant increase in complexity of patient care in all practice settings. Changing patient demographics require complex planning for co-morbidities associated with chronic diseases and life-saving advances that have altered mortality in ways never before imagined. These changes in practice, coupled with findings from sophisticated nursing research and the continuous development of new nursing knowledge, call for realignments of the relationships among academic faculty in schools of nursing, advanced practice nurse administrators, and staff nurses at the forefront of practice. This article offers a model designed to bridge the gaps among academic settings, administrative offices and the euphemistic "bedsides" where staff nurses practice. Here we describe the nurse attending model in place at the New York University Langone Medical Center (NYULMC) and provide qualitative data that support progress in our work.